Cohort profile : Oxford Pain, Activity and Lifestyle (OPAL) Study, a prospective cohort study of older adults in England

Purpose: The ‘Oxford Pain, Activity and Lifestyle’ (OPAL) Cohort is a longitudinal, prospective cohort study of adults, aged 65 years and older, living in the community which is investigating the determinants of health in later life. Our focus was on musculoskeletal pain and mobility, but the cohort is designed with flexibility to include new elements over time. This paper describes the study design, data collection and baseline characteristics of participants. We also compared the OPAL baseline characteristics with nationally representative data sources. Participants: We randomly selected eligible participants from two stratified age bands (65–74 and 75 and over years). In total, 5409 individuals (42.1% of eligible participants) from 35 general practices in England agreed to participate between 2016 and 2018. The majority of participants (n=5367) also consented for research team to access their UK National Health Service (NHS) Digital and primary healthcare records. Findings: to date Mean participant age was 74.9 years (range 65–100); 51.5% (n=2784/5409) were women. 94.9% of participants were white, and 28.8% lived alone. Over 83.0% reported pain in at least one body area in the previous 6 weeks. Musculoskeletal symptoms were more prevalent in women (86.4%). One-third of participants reported having one or more falls in the last year. Most participants were confident in their ability to walk outside. The characteristics of OPAL Cohort participants were broadly similar to the general population of the same age. Future plans: Postal follow-up of the cohort is being undertaken at annual intervals, with data collection ongoing. Linkage to NHS hospital admission data is planned. This English prospective cohort offers a large and rich resource for research on the longitudinal associations between demographic, clinical, and social factors and health trajectories and outcomes in community-dwelling older people

Formation of Millisecond Pulsars from Accretion Induced Collapse and Constraints on Pulsar Gamma Ray Burst Models

We study accretion induced collapse of magnetized white dwarfs as an origin of millisecond pulsars. We apply magnetized accretion disk models to the pre-collapse accreting magnetic white dwarfs and calculate the white dwarf spin evolution. If the pulsar magnetic field results solely from the flux-frozen fossil white dwarf field, a typical millisecond pulsar is born with a field strength $\sim 10^{11}-10^{12}G$. The uncertainty in the field strength is mainly due to the uncertain physical parameters of the magnetized accretion disk models. A simple correlation between the pulsar spin $\Omega_*$ and the magnetic field $B_*$, $(\Omega_*/10^4s^{-1})\sim (B_{*}/10^{11}G)^{-4/5}$, is derived for a typical accretion rate \sim 5\times 10^{-8}M_{\sun}/yr. This correlation remains valid for a wide pre-collapse physical conditions unless the white dwarf spin and the binary orbit are synchronized prior to accretion induced collapse. We critically examine the possibility of spin-orbit synchronization in close binary systems. Using idealized homogeneous ellipsoid models, we compute the electromagnetic and gravitational wave emission from the millisecond pulsars and find that electromagnetic dipole emission remains nearly constant while millisecond pulsars may spin up rather than spin down as a result of gravitational wave emission. We also derive the physical conditions under which electromagnetic emission from millisecond pulsars formed by accretion induced collapse can be a source of cosmological gamma-ray bursts. We find that relativistic beaming of gamma-ray emission and precession of gamma-ray emitting jets are required unless the dipole magnetic field strengths are $>10^{15}$G; such strong dipole fields are in excess of those allowed from the accretion induced collapse formation process except in spin-orbit synchronization.Comment: 36 pages, AASLATEX, 4 ps figures, Ap

Distribution of Fe3+ and H in Minerals During Partial Melting and Metasomatism of Spinel Peridotite

Oxygen fugacity and water content are crucial parameters for many chemical and physical properties of the Earth's mantle, for example bearing on fluid type, melting initiation, and deformation. However, the exact behaviour of Fe3+ and H during melting and metasomatism is still under debate. Here, the Fe3+/Fe ratio (Mssbauer and EMP) and water content (FTIR) of peridotite minerals are examined in mantle xenoliths from Kilbourne Hole (KH), NM, and Dish Hill (DH), CA (USA). These spinel peridotites have compositions consistent with partial melting with variable degrees of metasomatism (undetectable to cryptic to modal). Pyroxenites also allow to examine melt-rock reactions. Bulk-rock Fe2O3 content of the KH peridotites correlates with indices of melting (positive with bulk-rock Al2O3 and Cpx Yb contents, and negative with spinel Cr#) confirming that Fe3+ behaves as an incompatible element during melting. Correlations of the Fe3+/Fe ratio of minerals with these indices, however, indicates that Fe3+ is incompatible in Cpx but compatible in Opx and spinel during melting. Water contents in olivine, Cpx and Opx from most KH peridotites can be explained by partial melting and correlate negatively with the Fe3+/Fe ratio of spinel and Opx but positively with that of Cpx. This indicates partial control of Fe3+ on the incorporation of H in pyroxene, but not related to a redox equilibrium in Cpx. The higher Fe3+/Fe ratio of spinel in the metasomatized KH and DH peridotites, and in the pyroxenites confirms that oxidation characterizes modal metasomatism. Metasomatism, however, is not necessarily accompanied by water addition

Falls and mobility in Parkinson's disease: protocol for a randomised controlled clinical trial

Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson\u27s disease, this has not yet been confirmed with a large scale randomised controlled clinical trial. The study will investigate the effects on falls, mobility and quality of life of (i) movement strategy training combined with falls prevention education, (ii) progressive resistance strength training combined with falls prevention education, (iii) a generic life-skills social program (control group). Methods/Design People with idiopathic Parkinson\u27s disease who live at home will be recruited and randomly allocated to one of three groups. Each person shall receive therapy in an out-patient setting in groups of 3-4. Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks. All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase. Assessments will occur before therapy, after the 8 week therapy program, and at 3 and 12 months after the intervention. A falls calendar will be kept by each participant for 12 months after outpatient therapy. Consistent with the recommendations of the Prevention of Falls Network Europe group, three falls variables will be used as the primary outcome measures: the number of fallers, the number of multiple fallers and the falls rate. In addition to quantifying falls, we shall measure mobility, activity limitations and quality of life as secondary outcomes. Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson\u27s disease who live at home

Unveiling the Origin of Grb 090709A: Lack of Periodicity in a Reddened Cosmological Long-Duration Gamma-Ray Burst

We present broadband (gamma-ray, X-ray, near-infrared, optical, and radio) observations of the Swift gamma-ray burst (GRB) 090709A and its afterglow in an effort to ascertain the origin of this high-energy transient. Previous analyses suggested that GRB 090709A exhibited quasi-periodic oscillations with a period of 8.06 s, a trait unknown in long-duration GRBs but typical of flares from soft gamma-ray repeaters. When properly accounting for the underlying shape of the power-density spectrum of GRB 090709A, we find no conclusive (>3σ) evidence for the reported periodicity. In conjunction with the location of the transient (far from the Galactic plane and absent any nearby host galaxy in the local universe) and the evidence for extinction in excess of the Galactic value, we consider a magnetar origin relatively unlikely. A long-duration GRB, however, can account for the majority of the observed properties of this source. GRB 090709A is distinguished from other long-duration GRBs primarily by the large amount of obscuration from its host galaxy (A_(K,obs) ≳ 2 mag)

Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial

Background Cost of illness studies show that Parkinson disease (PD) is costly for individuals, the healthcare system and society. The costs of PD include both direct and indirect costs associated with falls and related injuries. Methods This protocol describes a prospective economic analysis conducted alongside a randomised controlled trial (RCT). It evaluates whether physical therapy is more cost effective than usual care from the perspective of the health care system. Cost effectiveness will be evaluated using a three-way comparison of the cost per fall averted and the cost per quality adjusted life year saved across two physical therapy interventions and a control group. Conclusion This study has the potential to determine whether targetted physical therapy as an adjunct to standard care can be cost effective in reducing falls in people with PD

Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research

<b>Background</b> Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.<p></p> <b>Methods and findings</b> The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.<p></p> <b>Conclusions</b> Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems

Searches at HERA for Squarks in R-Parity Violating Supersymmetry

A search for squarks in R-parity violating supersymmetry is performed in e^+p collisions at HERA at a centre of mass energy of 300 GeV, using H1 data corresponding to an integrated luminosity of 37 pb^(-1). The direct production of single squarks of any generation in positron-quark fusion via a Yukawa coupling lambda' is considered, taking into account R-parity violating and conserving decays of the squarks. No significant deviation from the Standard Model expectation is found. The results are interpreted in terms of constraints within the Minimal Supersymmetric Standard Model (MSSM), the constrained MSSM and the minimal Supergravity model, and their sensitivity to the model parameters is studied in detail. For a Yukawa coupling of electromagnetic strength, squark masses below 260 GeV are excluded at 95% confidence level in a large part of the parameter space. For a 100 times smaller coupling strength masses up to 182 GeV are excluded.Comment: 32 pages, 14 figures, 3 table

Measurements of Transverse Energy Flow in Deep-Inelastic Scattering at HERA

Measurements of transverse energy flow are presented for neutral current deep-inelastic scattering events produced in positron-proton collisions at HERA. The kinematic range covers squared momentum transfers Q^2 from 3.2 to 2,200 GeV^2, the Bjorken scaling variable x from 8.10^{-5} to 0.11 and the hadronic mass W from 66 to 233 GeV. The transverse energy flow is measured in the hadronic centre of mass frame and is studied as a function of Q^2, x, W and pseudorapidity. A comparison is made with QCD based models. The behaviour of the mean transverse energy in the central pseudorapidity region and an interval corresponding to the photon fragmentation region are analysed as a function of Q^2 and W.Comment: 26 pages, 8 figures, submitted to Eur. Phys.